Primary amyloidosis

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Amyloidosis on the face

Amyloidosis on the fingers

Amyloid - primary

• fatigue
• numbness of hands and feet
• weak hand grip
• weight loss
• shortness of breath
• swelling of the extremities
• swallowing difficulties
• irregular heart rhythm
• skin changes
• enlarged tongue

• weakness
• urine output, decreased
• other tongue problems
• stools, clay colored
• diarrhea
• joint pain
• hoarseness or changing voice

Your doctor may discover that you have an enlarged liver or spleen. There may be signs of heart failure.

If specific organ damage is suspected, testing to confirm amyloidosis of that organ may be performed. For example:

• biopsy of a tissue or organ will be positive for amyloid. A skin biopsy that includes subcutaneous fat, a rectal mucosa biopsy, or a bone marrow biopsy can help confirm the diagnosis.
• heart evaluation may reveal arrhythmias, abnormal heart sounds, or signs of heart failure.
  • ECG shows abnormalities.
  • echocardiogram shows poor wall motion because of a stiff heart muscle (cardiomyopathy).
• kidney function evaluation may reveal renal failure or nephrotic syndrome (excessive protein in the urine).
  • Urinalysis shows protein, casts, or fat bodies.
  • Serum creatinine is increased.
  • BUN is increased.
• abdominal ultrasound may reveal enlarged liver or spleen.
• evaluation for carpal tunnel syndrome may reveal involvement of the nerve:
  • nerve conduction velocity shows a conduction block.
  • hand grips are weak because of weakness of the thumb.

This disease may also alter the results of the following tests:

• tongue biopsy
• nerve biopsy
• myocardial biopsy
• gum biopsy
• carpal tunnel biopsy
• Bence-Jones protein (quantitative)
• immunoelectrophoresis - serum
• quantitative immunoglobulins
• urine protein

Review Date: 04/15/2005
Reviewed By: Rita Nanda, MD, Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network.